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Flashcards in Neuro Deck (74):
1

bilateral amygdala lesion

Kluver-Bucy syndrome (hyperorality, hypersexuality, disinhibited behavior, extreme curiosity putting things in mouth) Associated with HSV-1

2

frontal lobe lesion

disinhibition and deficits in concentration, orientation, and judgement; may have reemergence of primitive reflexes

3

R (non dominant) parietal lobe lesion

spatial neglect (agnosia of contralateral side of world)

4

Reticular activating system (midbrain)

reduced levels of arousal and wakefulness (ie coma)

5

Mamillary bodies

Wernicke-Korsakoff syndrome (firs: ataxia, ophthalmoplegia, confusion; korsakoff - memory loss, confabulation, personality change)

6

Basal ganglia

tremor at rest, chorea, or athetosis

7

Cerebellar hemisphere

intention tremor, limb ataxia; damage to the cerebellum results in ipsilateral deficits; fall toward side of lesion (cerebellum -> SCP -> contralateral cortex -> corticospinal decussation = ipsilateral)

8

Cerebellar vermis lesion

truncal ataxia, dysarthria

9

subthalamic nucleus lesion

contralateral hemibalismus

10

hippocampus lesion

anterograde amnesion (no new memories)

11

Paramedian pontine reticular formation (PPRF) lesion

Eyes look away from side of lesion

12

Frontal eye fields lesion

eyes look toward lesion

13

Athetosis

slow, writhing movements, especially of fingers. Basal ganglia lesion; often seen in Huntington's

14

Myclonus

sudden, brief muscle contraction

15

Dystonia

Sustained, involuntary muscle contraction

16

Broca's aphasia

can't speak but can understand; inferior frontal gyrus [ on non-dominant side can't express emotion or inflection in speech ]

17

wernicke's aphasia

can't understand but can speak; superior temporal gyrus [ non-dominant side can't comprehend emotion or inflection in speech ]

18

Global aphasia

both broca and wernicke; nonfluent aphasia

19

Conduction

poor repitition but fluent speech, intact comprehension; acruate fasciculus (can't repeat pharses such as no ifs, ands, or buts)

20

Watershed lesion

man in a barrell; higher order visual processing

21

Wallenberg (PICA lesion

ipsilateral horners, ataxia, vertigo/vomiting, contralateral pain and temp loss, ipsilateral pain and temp loss from face, nucleus ambiguus so loss of swallowing/hoarsness/gag reflex

22

Anterior spinal artery lesion

Loss of pyramids so contralateral hemiparesis of lower limbs, decreased propriception from loss of medial lemniscus, ipsilateral hypoglossal dysfunction from hypoglossal nucleus lesion

23

AICA lesion

occurs in lateral pons - hist nucleus VII, VI, Vestiubular nucleus, sympathetics, spinal trigeminal: Facial nerve defects such as paralysis, loss of taste from ant tongue, no corneal reflex, reduced ipsilateral hearing because of cochlear nucleus, ipsilateral horner's, decreased lacrimation and salivation--- facial droop

24

berry aneurysm of posterior communicating arteries

CN III - palsy due to compression

25

Weber syndrome (paramedial branches of PCA)

lesions the substantia nigra (contralateral parkinson), corticospinal tract (contralateral paresis), corticobulbar tract (facial muscles), oculomotor nerve fibers (ipsilateral CN III)

26

wednig hoffman disease

autosomal recessive disease, also known as infantile spinal muscular atrophy; presents with floppy baby, tongue fasciculations at birth, death by 7 months. Degeneration of anterior horns (LMN involvement only just like polio and west nile)

27

biceps reflex

C5, 6

28

triceps reflex

C7, 8

29

Patella reflex

L4, 3

30

Achilles reflex

S1, 2

31

Moro reflex

hang on for life newborn reflex

32

rooting reflex

nipple seeking

33

sucking reflex

sucking when roof of mouth is touched

34

palmar and plantar reflexes

curling of fingers or toes on touching palms or soles

35

gallant reflex

stroking along one side of spine causes lateral flexion of lower body toward stimulated side

36

Perinaud syndrome

lesion of superior colliculus; disrupts conjugate verticle gaze

37

cavernous sinus syndrome

Ophthalmoplegia plus V1 and V2 sensory loss. CNs III, IV, V1 V2, VI run through plus the internal carotid

38

muscles of mastication

lateral pterygoid opens mouth; masseter, temporalis and medial pterygoid closes

39

Migraine

female, fam history, unilateral, pulsatile/throbbing, 4 to 72 hours, auras, photophobia, nausea

40

Cluster headache

Male, no fam hx, onset during sl, behind eye, excruiating sharp and steady, 15 to 90 min, sweating, facial flushing, nasal congestion lacrimation, pupillary changes

41

Tension headache

female, usually from stress, band-like pattern around head (bilateral vs. migrain unilaterality), dull tight and persistent pain (versus throbbing like migraine), 30 min to 7 days, muscle tenderness in head neck or shoulders

42

Thalamic syndrome

vascular lesion of thalamus results in VPL and VPM nuclei damage causing contralateral sensory loss of both face and body

43

lipohyalinosi

the primary cause of lacunar infarcts along with microatheromas. They are believed to be priary cause of lacunar infarcts. It is a destructive vessel lesion characterized by loss of normal arterial architecture, mural foam cells.

44

area postrema

specialized fenestrated capilary region allows brain to sample chemicals and is responsible for vomiting reflex (lies in dorsal medulla near fourth ventricle).

45

meniere's disease

disorder of inner ear d/t increased volume of endolymph maybe due to defective resorption of endolymph. Results in vestibular and cochlear components. Triad of tinnitus, vertigo, and sensorineural hearing loss

46

damaged in wilson's

lentiform nucleus (globus pallidus and putamen) [remember hepaticolenticular degeneration]; manifestations include wing-beating tremor, psychosis and cirrhosis.

47

Ring enhancing lesion differential

metastases, abscesses, toxoplasmosis, primary CNS lymphoma

48

essential tremor

samilial tremor. AD. Often improves with alcohol consumption. First line treatment is beta blockers

49

diabetic CN III neuropathy

CN III neuropathy is ischemic and does not involve the parasympathetics due to their alternative blood supply

50

S-100

Schwann cell and melanocyte because of neural crest origin

51

subacute sclerosing encephalitis

complication of measles from recovered disease years later. May be caused by virus that is missing antigen which allows them to avoid immune clearance and persists in CNS. CHILDREN have progressive dementia and neurologic deficits, slowly progressive but fatal. High antibody titer in CSF. Oligoclonal bands, but NO antibodies to M-component (antigen) of virus.

52

Progressive multifocal leukoencephalopathy

caused by JC virus. Papova family (circular DNA)

53

Hyperpyrexia

temp greater than 40 C. can lead to permanent brain damage. Emergent treatment is cold blankets. Can be triggered by inflammation via exogenous pyrogens or drugs or malignancy. IL-1 and IL-6 and TNF mediated. Stimulate arachidonic acid from cell membranes by PL-A2 synthsis of PGE2 leads to increase in thermoregulatory set point (this is why aspirin and acetomenonphin are fever reducers). Purkinje cells of cerebellum especially sensitive to high temps.

54

Cerebral amyloid angiopathy

recurrent lobar hemorrhages in elderly patients. Beta amyloid deposited into arterial wall leading to weakening of the wall and predisposition to rupture. Cerebral amyloid angiopathy is associated with advanced age and is not related to systemic amyloidosis. Recurrent hemorrhagic stroke is most common presentation. Less severe than hemorrhages via HTN. Occur in cerebral hemispheres (Vs HTN that involve basal ganglia)

55

Nucleus ceruleus

NE- secreting neurons; fight or flight response. Dorsal pons

56

Raphe nucleus

Serotonin neurons in brainstem Project throughout CNS. Sleep-wake cycle, arousal. Lesions lead to insomnia and depression. Antidepressants work by prolonging amount of time that serotonin spends in synaptic cleft.

57

Nucus basalis of Meynert

Ach neurons. Destroyed in alzheimers

58

Red nucleus

anterior midbrain. Motor coordination of upper extremities

59

Caudate nucleus

motor activities. Atrophy in huntington, loss of cholinergic and GABA-releasing neurons

60

Substantia Nigra

Dopaminergic neurons

61

caudate nucleus blood supply

deep branches of the ACA

62

Lentiform nucleus blood supply

inferior division of the MCA

63

Anterior and posterior limbs of the internal capsule

anterior limb is supplied by ACA deep branches (located next to caudate); posterior limb is supplied by the choroidal artery which is a branch off the internal carotid (also supplies optic tract, lateral geniculate body, choroid plexus, uncus, hippocampus and amygdala)

64

PCA supplies

CN III and IV and other mdibrain structures. Thalamus, mesial temporal, corpus callosum, parahippocampal gyrus, fusiform gyus, and occipital lobe

65

nerve physiology; time constant

the amount of time it takes for the membrane to change potential. Measure of capacitance; myelination decreases time constant thus allowing membrane potential to change more rapidly

66

Nerve physiology; length constant

measure of how far along an axon an electrical impulse can propagate; Myelination increases the length constant.

67

acetylcholinesterase in amniotic fluid

Neural tube defects along with AFP

68

POMC

proopiomelanocortin. A polypeptide precursor that goes through enzymatic cleavage and modification to produce not only beta-endorphins but also ACTH and MSH (this suggests a possibly close linkage between stress axis and opiod system)

69

Mu receptor action

morphine and opioid agonists activate G-protein Mu receptor which one of its many effects is to hyperpolarize a cell by increasing K efflux.

70

Paralysis of upward gaze

Parinaud syndrome (a dorsal midbrain syndrome) occurs in tumors of pineal region

71

Germinoma

most common tumor of the pineal gland, from embryonic germ cells, patients present with precocious puberty via hCG production. Aqueductal compression may result in hydrocephalus, and parinaud syndrome which includes paralysis of upward gaze and convergence (this is due to compression of tectal area)

72

polyhydramnios

excessive aumulation of amniotic fluid due to decreased swallowing or increased urination. Impaired swallowing can be due to gi obstruction and anencephaly.

73

synaptophysin

found in presynaptic vesicles of neurons, neuroendocrine and neuroectodermal cells. CNS tumors of neuronal origin stain positive for synaptophysin. Neoplasms of glial origin (astrocytomas, ependymomas, and oligodendrogliomas) stain GFAP

74

germinal matrix

common area of bleeding in prematrue babies into the lateral ventricles. It is a highly cellular and vascularized layer in the sventricular zone from which neurons and glial cells migrate out during brain development. Matrix contains numerous thin-walled vessels lacking glial fibers that support other blood vessels throughout brain